Factors Associated with the “Bamboo Spine” Phenotype – Data from the Comospa Study

Koei Oh¹, Anna Molto², Corinne Miceli-Richard³, Soksay Singvongsa⁴, Adrien Etcheto⁴ and Maxime Dougados⁴, ¹Departmen of Rheumatology, Paris Descartes University, Hôpital Cochin, Paris, France, ²Hôpital Cochin, Department of Rheumatology, Paris Descartes University, Paris, France, ³Department of Rheumatolgy, Paris Descartes University, Hôpital Cochin, Paris, France, ⁴Department of Rheumatology, Paris Descartes University, Hôpital Cochin, Paris, France

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: axial spondyloarthritis, cross-sectional studies, epidemiologic methods and multicenter study

Session Information

Date: Sunday, November 5, 2017

Session Title: Spondyloarthropathies and Psoriatic Arthritis – Clinical Aspects and Treatment Poster I

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: The factors associated with “Bamboo spine” occurrence, i.e. the most severe axial phenotype of SpA patients, have been poorly assessed to date. The aim of this study was to clarify the factors associated with the severe type of AS “Bamboo spine” by investigating associations with various demographics, clinical and functional outcomes.

Methods: 275 patients with Bamboo spine enrolled by ASAS-COMOSPA study (Cross-sectional international study involving 22 countries and including 3984 SpA patients fulfilling the ASAS SpA criteria) were included in the analysis. Demographic, Clinical, and biological characteristics were compared between Bamboo-spine and non-Bamboo spine patients. Variables with significant difference in univariate analyses were used as dependent variables in multivariable and logistic regression. A logistic regression was used for the analysis to clarify the parameters associated with the Bamboo spine phenotype. Independent variables with a p value less than 0.2 in univariate linear/logistic regression analysis were tested in multivariate regression models. Odds ratio (ORs) with 95% CIs were calculated.

Results: Results of the univariate analysis are provided in the table. Multivariate analysis showed that Bamboo spine phenotype was independently associated with NSAIDs intake from first symptom (OR 4.29; 95% CI 1.45-12.71 P<0.02), male gender (OR 4.09; 95% CI 2.37-7.05; P<0.02), HLA-B27 positivity (OR 2.26; 95% CI 1.34-3.83; P<0.02), increased CRP (OR 1.76; 95% CI 1.20-2.60; P<0.02), osteoporosis (OR 1.52; 95% CI 0.99-2.34; P=0.05), with only a trend for smoking (OR 1.38, 95% CI 0.97-1.98; P=0.07).

Conclusion: The results of this study confirm parameters that have been previously associated with axial structural severity (longer disease duration, uveitis, smoking, HLA-B27 and male gender). NSAIDs have been reported to have a potential protective effect on the structural progression of the disease. Nevertheless, in this cross sectional study, NSAIDs intake from the first symptoms was associated with the Bamboo spine phenotype, suggesting that severe axial involvement leads to a sustained NSAIDs intake for pain relief. This also suggest that patients evolving to a bamboo spine phenotype have not been under-exposed to NSAIDs treatment and/or that NSAIDs sustained exposure is not sufficient to protect from Bamboo spine phenotype.

Disclosure: K. Oh, None; A. Molto, None; C. Miceli-Richard, None; S. Singvongsa, None; A. Etcheto, None; M. Dougados, None.

To cite this abstract in AMA style:

Oh K, Molto A, Miceli-Richard C, Singvongsa S, Etcheto A, Dougados M. Factors Associated with the “Bamboo Spine” Phenotype – Data from the Comospa Study [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/factors-associated-with-the-bamboo-spine-phenotype-data-from-the-comospa-study/. Accessed October 26, 2021.

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